Provider Demographics
NPI:1023884806
Name:LEGACY MEDICS LLC.
Entity type:Organization
Organization Name:LEGACY MEDICS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:P
Authorized Official - Last Name:MINOR
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:225-229-8925
Mailing Address - Street 1:4550 JONESBORO RD.
Mailing Address - Street 2:A2 #164
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291
Mailing Address - Country:US
Mailing Address - Phone:678-435-9160
Mailing Address - Fax:888-418-6110
Practice Address - Street 1:7821 ROCK ROSE LANE
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213
Practice Address - Country:US
Practice Address - Phone:678-435-9160
Practice Address - Fax:888-418-6110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)